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Chart Utilization Review Jobs in Raleigh, NC (NOW HIRING)

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Chart Utilization Review information

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$20

$41

$67

How much do chart utilization review jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for chart utilization review in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a chart utilization review specialist, and why are they important?

To thrive as a Chart Utilization Review specialist, you need a background in healthcare, strong knowledge of medical terminology, and experience with patient care documentation, often supported by an RN or LPN license. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately reviewing charts and collaborating with healthcare providers. These abilities ensure compliance, optimize patient care, and support cost-effective healthcare delivery.

What is chart utilization review?

Chart Utilization Review is a process commonly used in healthcare settings to assess the necessity, appropriateness, and efficiency of medical services provided to patients. It involves reviewing patient charts and medical records to ensure that treatments and procedures are justified according to established guidelines and policies. This process helps in improving patient care, managing costs, and ensuring compliance with regulatory requirements. Utilization review professionals work closely with medical staff, insurance companies, and regulatory agencies to support quality and cost-effective care.

What are some common challenges faced by professionals in chart utilization review, and how can they be addressed?

Professionals in Chart Utilization Review often encounter challenges such as navigating incomplete or inconsistent medical documentation, staying current with ever-evolving healthcare regulations, and balancing productivity with accuracy. To address these challenges, it is important to maintain open communication with clinical staff, participate in ongoing training, and utilize robust electronic health record systems. Additionally, collaborating closely with interdisciplinary teams can help clarify documentation and ensure compliance with regulatory standards.

What is the difference between Chart Utilization Review vs Chart Review Specialist?

AspectChart Utilization ReviewChart Review Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires medical or coding certifications
Work EnvironmentHealthcare facilities, insurance companies, utilization management teamsMedical offices, insurance companies, coding firms
Employer & IndustryHospitals, insurance providers, healthcare organizationsMedical billing companies, insurance firms, healthcare providers
Primary FocusAssessing medical necessity and appropriateness of servicesReviewing medical records for coding accuracy and completeness

While both roles involve reviewing medical information, Chart Utilization Review focuses on evaluating the necessity of healthcare services, whereas Chart Review Specialists primarily verify medical documentation for coding and billing accuracy. Understanding these distinctions helps professionals choose the right career path or job search focus.

What are popular job titles related to Chart Utilization Review jobs in Raleigh, NC? For Chart Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Chart Utilization Review jobs in Raleigh, NC look for? The top searched job categories for Chart Utilization Review jobs in Raleigh, NC are:
Chart Utilization Review jobs near you
Infographic showing various Chart Utilization Review job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $85,491 per year, or $41.1 per hour.

Weekend Clinical Manager, Registered Nurse

Well Care Health

Fuquay Varina, NC

Full-time

Posted 3 days ago

New

Job description

The Clinical Manager is responsible for the oversight of a clinical multi-disciplinary team, including the planning, controlling, organizing and leading of the team in the provision of effective and efficient clinical services. The Clinical Manager supervises, supports, and educates staff at the point of service in the field. The Clinical Manager supports an efficient and accurate revenue cycle by enhancing capture of appropriate revenue and managing the flow of documentation within their department to minimize days in accounts receivable.

PRIMARY JOB DUTIES

Oversees an interdisciplinary team which manages an active patient census as determined by the Sr Director of Home Health Operations.

Provides direct supervision of interdisciplinary team.

Ensures effective utilization of team resources in patient care delivery that is quality oriented and cost efficient.

Contributes to program effectiveness.

Organizes and performs work effectively and efficiently.

Maintains and promotes customer satisfaction.

JOB SPECIFICATIONS

Education: Graduate from an accredited or approved school of nursing or physical therapy. Bachelors degree preferred.

Licensure / Certification: Current license to practice professional nursing or physical therapy in the State in which supervising staff/care (NC/SC).

Experience: Minimum of two years clinical practice. Two years home health experience and six hours, or the equivalent of education training in public health and principles of management preferred. Prior experiences that would encompass clinical, teaching and supervisory practice within a nursing service organization is preferred.

Essential Technical Skills: Current knowledge of fundamental medical-surgical and home health nursing principles and practice. Knowledge of the principles of adult learning. Knowledge of standards of medical record keeping. Ability to speak clearly and effectively before small and large groups. Ability to communicate, both orally and in writing, and to be literate in the English language.

Interpersonal Skills: Excellent interpersonal skills including the ability to interact and communicate in a professional and tactful manner with coworkers, physicians, patients and families and the general public. Must be flexible and innovative

Essential Physical Requirements: Ability to stand or sit for extended periods of time when orienting/training. Requires ability to stoop or kneel, bend, push, reach with hands/arms when supervising-precepting staff in patient care activities or providing direct patient care.

Essential Mental Requirements: Ability to coordinate resources of the agency. Ability to facilitate cooperation and communication among team members. Demonstrate long and short term memory. High level problem solving and reasoning skills to assist staff in patient care planning and problem resolution. Able to prioritize duties, learn new skills and use supportive services appropriately. Must work well independently.

Essential sensory requirements: Ability to use sight to assess, plan, implement and evaluate patient care activities. Ability to use hearing to communicate with staff.

Exposure to Hazards: Noise, exposure to office equipment and machinery. Requires long periods of computer and chart review. Travel required. May encounter temperature changes and weather extremes.

Other - Hours of Work: Monday - Friday, weekends and holidays as needed. Occasional need for flexible hours to meet educational needs of staff and the agency. Able to rotate call and respond to assist as needed while on call.

Must have a valid North Carolina driver's license and an operational vehicle.

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